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Article Summaries for October 2018 Psychosomatic Medicine, Volume 80, Issue 8

doi: 10.1097/PSY.0000000000000641

Somatic symptom disorder (SSD) has been associated with autonomic dysfunction. In patients with SSD and healthy controls, Lee et al. measured heart rate variability (HRV) during performance of an attentional bias test (the emotional face dot-probe task). Patients with SSD had lower HRV during rest indicating less parasympathetic nervous system activity than controls and displayed altered reactivity to the attentional bias task. Resting-state autonomic activity was correlated with SSD patients’ heartbeat perception error. The findings suggest that disturbed interactions between the autonomic nervous, affective, and interoceptive systems may be involved in the pathophysiology of SSD.

Pages 690–697;

Irritable bowel syndrome (IBS) has been found to co-occur with intestinal microbial alterations. A bidirectional interplay between the gut microbiome and psychological stress may be of importance in IBS. Peter et al. explored these associations and report that psychological distress is associated with gut microbiota composition. A microbial signature corresponding with psychological distress was identified. Further characterization of gut bacteria might lead to discovery of new biobehavioral processes relevant to the diagnosis and therapies for IBS.

Pages 698–709;

Attachment style affects emotion regulation and an individual’s response to stressors, which may have implications for individuals with eating disorders. Monteleone et al. explored relationships between insecure attachment and the cortisol awakening response (CAR) in 78 adults with eating disorders. High levels of attachment anxiety were associated with a blunted CAR, whereas high attachment avoidance was not related to the CAR. Future studies are needed to clarify the role of adult attachment styles in the social stress response in eating disorders.

Pages 710–716;

Revealing one’s sexual identity to others is a complex process marked by a shift in the types of stressors faced by sexual minority young adults. The influence of sexual identity disclosure on the stress hormone cortisol remains poorly understood. Manigault et al. examined disclosure context and diurnal cortisol in 58 sexual minority adults aged 18 to 35 years. Greater total disclosure and disclosure to family members was associated with reduced cortisol output whereas disclosure to co-workers, friends, acquaintances or religious groups was unrelated to cortisol output.

Pages 717–723;

Serving the well-being of others is associated with mental and physical health benefits. The neural mechanisms are not well understood. Inagaki and Ross used an emotional faces task and functional magnetic resonance imaging to examine neural regions that, in animals, have been known to contribute to effective parental care. Participants also answered questions about their behavior related to providing support to others. Results suggested that giving targeted support to an identifiable individual in need—but not untargeted support—is associated with reduced amygdala reactivity in the emotional faces task.

Pages 724–732;

Allostatic load may explain pathways linking food insecurity and chronic disease. McClain et al. examined the association of food insecurity with 5-year allostatic load and dysregulation in primary (neuroendocrine, inflammation) and secondary (metabolic, cardiovascular) subsystems in Puerto Rican adults. The study was based on the Supplemental Nutrition Assistance Program (SNAP), and participation in the SNAP intervention was examined as a moderating factor. Food insecurity was associated with dysregulated components of the primary allostatic load system. The relationship was stronger for those not receiving SNAP, emphasizing its role in psychobiological health.

Pages 733–741;

Depression and anxiety are highly prevalent in patients with cardiovascular disease (CVD) and influence CVD prognoses and mental well-being. In a systematic review and meta-analysis, Reavell et al. investigated the effectiveness of cognitive behavioral therapy (CBT) for depression and anxiety in CVD patients. At follow-up, depression and anxiety scores were both significantly lower in CBT patients compared to controls. Reductions in depression were greatest at short-term follow-up. Anxiety symptoms, however, were most improved at long-term follow-up. Longer courses may be required to maintain psychological well-being in patients with CVD.

Pages 742–753;

Depression after stroke and myocardial infarction is common but may be undertreated. In a systematic meta-analysis, Ladwig et al. compared the pooled frequencies of antidepressant treatment use in depression after stroke or myocardial infarction. The results show that the majority of affected persons remain untreated, while depression is more frequently treated after stroke (24% of patients with depression) than after myocardial infarction (14% of patients with depression). Strategies to increase the use of efficacious treatments are needed.

Pages 754–763;

The type of emotion regulation strategies employed by adolescents may affect how chronic family stress affects important metabolic and immune processes. Jones et al. assessed strategy selections in the association between chronic family stress and adolescents’ physiological health. Greater cognitive reappraisal in the face of more chronic family stress was associated with better metabolic health (e.g., waist-to-hip ratio), whereas more suppression— inhibition of overt emotional expression in response to stressful stimuli—was associated with poorer functional immunity (e.g., greater glucocorticoid resistance).

Pages 764–773;

Associations between psychosocial stress and cardiovascular disease (CVD) may be strongest among stress-reactive individuals. In healthy working adults who were monitored during daily living, Kamarck et al. found that high demand/low control activities were linked with greater carotid artery atherosclerosis, but only among those showing greater blood pressure responses to these activities. Similar effects were reported for exposure and response to social conflict. Blood pressure reactivity may moderate the effects of psychosocial stress on CVD, and such effects may be detectable using ambulatory monitoring methods.

Pages 774–782;

Copyright © 2018 by American Psychosomatic Society